When Do Kids Need Physical Therapy in School?

 

Learn more about how kids qualify for physical therapy in school settings from a school-based pediatric PT.

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I am a pediatric physical therapist who has spent the majority of my career in the educational setting.  I have evaluated hundreds of kids from ages 3 – 22 and determined the need for my services within a school building.  

How do kids qualify for physical therapy in school?

In order for kids to qualify for school-based physical (or occupational) therapy, they must demonstrate a deficit in skills that affect their ability to participate in their environment with same-aged peers.  

For physical therapy, the “ability to participate” can be further broken down into some key things to look for:

1 || Can the child navigate his classroom without tripping or falling over obstacles (desks, chairs, kids, rugs, etc).

2 || Can she get up from circle time at the floor, sit down on the floor from standing, get in and out of a classroom chair without a loss of balance.

3 || Can he negotiate the hallways with and without other students without falling or needing help to stay in line or keep pace with his peers.

4 || On the playground, can she participate in recess activities with her friends.  Can she climb the slide, sit safely on a swing, walk or run on the grass/blacktop/rubber mulch.

5 || Are his gross motor skills (jumping, throwing/catching/kicking a ball, hopping, galloping, etc) developed enough to allow him to participate in a form of physical education class?

6 || Can she safely get onto and off of the bus?

I think you get the picture – in order for a child to qualify for direct or consultative physical therapy services, the child must have a deficit that is limiting their function throughout their school day.

He just seems uncoordinated…

Recently, I have been getting a ton of requests to screen kids because they “can’t do a jumping jack”, “seem uncoordinated”, “can’t alternate on the stairs”, etc.  The kids that I am referring to are typically in 3rd grade or older and have never been noted to have difficulties before.

If I were to screen every child in a school building, I’m almost certain that many (if not the majority) of kids would not be able to do a solid jumping jack.  I am even pretty sure that I would find several that can’t alternate or chose not to alternate (because they feel faster) on the stairs.

But consider this…after reading the list above, is the inability to complete a coordinated jumping jack cause for physical therapy intervention in the educational environment?

I would say no!

An outpatient physical therapist could certainly address this issue and could probably find a lot more to work on with a child related to his bilateral coordination and core strength.

As for the stairs, as long as a child is able to safely ascend and descend the stairs, with and without the traffic of his peers, then the pattern isn’t so critical.  This immaturity in skill is probably related to lack of exposure to stairs earlier in life.

So what about those kids who “just seem uncoordinated”?

So teachers….what should you do with these kids that are in your classroom that seem to be “off” in comparison with the other children, but might not qualify for physical therapy in school?  Here are some ideas:

1 || Incorporate movement into your lesson plans!  Try the 56 ideas in our book Playful Learning Lab:  Whole Body Sensory Adventures to Enhance Focus, Engagement and Curiosity.  In this book, we move through topics in every subject (math, social studies, science, literature, art, music and more).  Learning doesn’t have to be stationary, in a desk, sitting upright in a chair. Inspire your kids to move while they learn!

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Check out all of our most creative and engaging learning activities in our book, Playful Learning Lab for Kids! This awesome resource contains tons of fun movement-based and multi-sensory learning activities targeting academic concepts in every subject from math to music and beyond! Grab your copy today!

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2 || Try some hallway waiting games to get kids moving during a time when they are typically just standing around.  They will get some extra exposure to balance, strengthening and sensory input.

3 || Don’t take recess away!!  Kids need to move to strengthen their bodies and improve their overall coordination.  The more they are exposed to free play and movement, the better their overall skills will be!  I can almost guarantee that they aren’t moving much when they get home from school (Fortnite anyone??).

4 || Provide sensory and movement breaks throughout the school day that children can use as they need for proprioceptive input, organizing their body, or strengthening their hands.  Sensory breaks aren’t just for kids who are labeled as having SPD.  Everyone needs a sensory break now and then.

There are lots of great ways to incorporate movement throughout the day to promote balance, coordination, motor planning, and more!

So the next time you’re thinking about making a PT referral, think about whether the deficits you are seeing are really impacting the child’s performance in school.  Maybe it’s a kid who has some quirky habits, is just slightly uncoordinated, or isn’t a star athlete on the field.  Maybe the child just needs some consistent practice to see results. Try the ideas above to provide some basic support in the classroom.  You might be surprised at the results!